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  4. Gene therapy-mediated overexpression of wild-type MFN2 improves Charcot-Marie-Tooth disease type 2A
 
preprint

Gene therapy-mediated overexpression of wild-type MFN2 improves Charcot-Marie-Tooth disease type 2A

Tessier, M.
•
Hamzé, Zeinab
•
Bonello‐Palot, Nathalie
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October 15, 2025

Charcot-Marie-Tooth disease type 2A (CMT2A) is the most common axonal CMT and is associated with an early onset and severe motor-dominant phenotype. CMT2A is mainly caused by dominant mutations in the MFN2 gene, encoding Mitofusin-2, a GTPase located in the outer membrane of the mitochondria and endoplasmic reticulum (ER). Mutations in MFN2 are known to affect mitochondrial dynamics. We previously demonstrated that the mutated MFN2 Arg94Gln further disrupts contacts between the ER and the mitochondria, leading to progressive axonal degeneration. There is no effective therapeutic approach to slow or reverse the progression of CMT2A, and treatments currently under development primarily focus on restoring mitochondrial function. Here, we provide proof-of-concept that neuronal overexpression of wild-type MFN2 (MFN2 WT ) provides therapeutic benefit in transgenic CMT2A mice carrying the mutated MFN2 Arg94Gln . Intrathecal delivery of an AAV9 vector expressing MFN2 WT effectively targets motor and sensory neurons, restoring ER-mitochondria contacts and mitochondrial morphology, thereby preserving both neuromuscular junction integrity and motor function. Strikingly, therapeutic efficacy is also achieved following vector injection after the onset of symptoms, rescuing the molecular hallmarks of CMT2A pathology and reversing locomotor. Notably, AAV administration was well tolerated, with no evidence neither of hepatotoxicity nor dorsal root ganglion inflammation. These results establish that boosting MFN2’s levels using gene therapy is a promising therapeutic avenue for CMT2A.

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Type
preprint
DOI
10.1101/2025.10.15.682364
Author(s)
Tessier, M.

Aix-Marseille Université

Hamzé, Zeinab

Aix-Marseille Université

Bonello‐Palot, Nathalie

Association for Project Management

Roeckel-Trévisiol, Nathalie

Inserm

Attarian, Shahram

Centre de Génétique Médicale de Marseille

Bartoli, Marc

Canadian Nautical Research Society

Delague, Valérie

Inserm

Schneider, Bernard L.  

École Polytechnique Fédérale de Lausanne

Bernard‐Marissal, Nathalie

Génétique Médicale & Génomique Fonctionelle

Date Issued

2025-10-15

Publisher

bioRxiv

Written at

EPFL

EPFL units
PTBTG  
FunderFunding(s)Grant NumberGrant URL

ANR

21-CE17-0033-01

Available on Infoscience
February 18, 2026
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/259679
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